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Risk of Recurrence and Mortality in a Multi-Ethnic Breast Cancer Population

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Background

Compared to non-Hispanic whites, African-American women tend to be diagnosed with breast cancer at an earlier age, to have less favorable tumor characteristics, and to have poorer outcomes from breast cancer. The extent to which differences in clinical characteristics account for the black/white disparity in breast cancer mortality is unclear. The purpose of this investigation was to examine the association of clinical, demographic, and treatment variables with total mortality and breast cancer recurrence by race/ethnicity in a cohort of women diagnosed with invasive breast cancer.

Methods

To this end, we used data on 3890 invasive breast cancer cases diagnosed at a single medical center. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association of tumor characteristics and treatment variables with mortality and recurrence.

Results

Compared to white women, black women with breast cancer presented with tumors that had worse prognostic factors, particularly higher stage, lower frequency of hormone-receptor positive tumors, and higher frequency of comorbidities. Hispanics also generally had less favorable prognostic factors compared to non-Hispanic whites. Among estrogen receptor-positive cases, blacks had roughly a two-fold increased risk of recurrence compared to non-Hispanic whites. However, ethnicity/race was not associated with total mortality. Tumor stage, tumor size, and Charlson comorbidity index were positively associated with mortality, and mammography and chemotherapy and hormone therapy were inversely associated with mortality.

Conclusion

In spite of poorer prognostic factors among blacks compared whites, race/ethnicity was not associated with total mortality in our study.

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Author information

Authors and Affiliations

  1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA

    Geoffrey C. Kabat, Mindy Ginsberg & Thomas E. Rohan

  2. Department of Medicine, Albert Einstein College of Medicine; Montefiore Medical Center, Bronx, NY, 10461, USA

    Joseph A. Sparano

Authors
  1. Geoffrey C. Kabat
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  2. Mindy Ginsberg
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  3. Joseph A. Sparano
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  4. Thomas E. Rohan
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Corresponding author

Correspondence to Geoffrey C. Kabat.

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Disclosure of Potential Conflicts of Interest

The authors declare that they have no competing interests.

Research Involving Human Participants

This study was approved the Institutional Review Board of the Albert Einstein College of Medicine. No animal subjects were included in this study.

Funding

This work was supported by institutional funds from the Albert Einstein College of Medicine.

Dr. Rohan receives support from the Breast Cancer Research Foundation.

We thank Dr. Chelsea Catsburg for her help in developing the breast cancer cohort.

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Kabat, G.C., Ginsberg, M., Sparano, J.A. et al. Risk of Recurrence and Mortality in a Multi-Ethnic Breast Cancer Population. J. Racial and Ethnic Health Disparities 4, 1181–1188 (2017). https://doi.org/10.1007/s40615-016-0324-y

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  • DOI: https://doi.org/10.1007/s40615-016-0324-y

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